• CIC Registered Nurse - Hybrid

    Commonwealth Care Alliance (Boston, MA)
    …intensive care management and care delivery. Within the CIC Program, the Registered Nurse (RN) serves as an integral member of an interdisciplinary team for medical ... needs of the defined panel of members, the Registered Nurse will engage in regular assessments, visits at regularly...as approved + Supports escalation of member grievances and appeals + Supports the procurement of network providers and… more
    Commonwealth Care Alliance (10/02/25)
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  • UM Service Coordinator - Hybrid - $22/hr

    Fallon Health (Worcester, MA)
    …authorization information in QNXT because of determinations made by Authorization Coordinators, Nurse Reviewers and/or Nurse Care Specialists. + Handles an ... contract information, benefits, etc.), including authorization details when requested for appeals . + Distributes departmental facsimiles; checks Right Fax no less… more
    Fallon Health (10/02/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    …agencies, to coordinate activities involved in medical record review, denials, appeals and reconsideration hearings. Works closely with the physician advisor to ... RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It...in the course of his/her regularly scheduled activities as associate of SHC Brockton Hospital and Signature Medical Group… more
    Brockton Hospital (09/12/25)
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